Good preparation and care after surgery can make all the difference.
Not all of the points below will apply to every patient, but Mr Litwin will specify which are most important to you and be on hand at every stage of your recovery.
Before the operation
- Unless prescribed by your GP, avoid Aspirin for 2 weeks prior to surgery.
- Dress comfortably and avoid jewellery, contact lenses and make-up.
- Take your usual medications.
- Do not have anything to eat for 6 hours prior to surgery. Clear fluids may be drunk until 2 hours before surgery.
After the operation
- Make sure you are being picked up after surgery and there is someone with you for 24 hours
- Please rest quietly all day following surgery. Avoid bending or excessive exercise for the first two days following surgery or as advised.
- Maintain an elevated head position and use two or three pillows at night for the first 3 days.
- Always wash your hands before and after treating your eye.
- You may have a pad on your eye. If so, then do not remove it until advised.
- Apply a cold compress immediately after patch is removed, and then several times per day. (See instructions below.)
- Apply your eye ointment as instructed by Mr Litwin (thinly, inside the lid from the inner corner outwards).
- You may need to take your usual painkillers for 48 hours after surgery. Take your anti-inflammatory and antibiotic medicine if prescribed.
- If your eye is sticky or has discharge around the suture line (stitches), bathe it using cooled boiled water. Close your eye and wipe gently from the inner corner to the outer corner, ensuring you use a fresh piece of cotton wool for each wipe.
- Observe your eye for severe swelling and telephone if it is getting worse or you are concerned.
Dos and don’ts
- You can watch television or read directly after surgery, but remember your vision may be blurry.
- Do not have hot drinks or hot food immediately after surgery, if you can, wait until the following day.
- If your surgery was under General Anaesthesia, do not have dairy products for the first 24 hours, as these may make you feel nauseous.
- Do not take a shower or a bath for the first day.
- Do not get soap into the incisions for the first week.
- Do not drive on the day of surgery. Wait until you can see a license plate clearly at 20m and the effects of any sedation have resolved. This is the legal requirement.
- Do not wear contact lenses for the first 2 weeks. This is to keep the risk of wound infection low.
- If you had tear duct surgery (dacryocystorhinostmy – DCR) or orbital surgery, do not blow your nose for 1 week.
Medications
Paracetamol: Take two 500mg tablets every four hours for 48 hours while awake, unless Mr Litwin has told you otherwise.
Chloramphenicol ointment: Chloramphenicol ointment is commonly prescribed to most patients following eyelid surgery. This is an antibiotic that is applied to the incision lines. It is also applied into the eye during the first week, to ensure that the surface of the eye remains moist if either your blink or eyelid closure has been temporarily weakened after eyelid surgery.
Apply it four times every 24 hours — three times a day and at night — to the operated eye and the incision lines on your eyelids. Begin the day after surgery.
To apply the ointment:
- Use one drop or 1/4 inch of ointment — a slight excess is not harmful.
- Look up and gently pull down on the skin over the cheekbone in order to bring the lower lid away from the eye enough to put apply ointment on the inner surface of the lower eyelid.
- Also apply ointment to incision lines on eyelids and ensure that these remain moist with ointment until you see Mr Litwin.
Steristrips and Stiches (Sutures)
If you have small white Steristrips on your wounds, leave these for four days. You can remove these, by just peeling them off. If they are difficult to remove, soak them in warm water for a few minutes first. If these fall off earlier, do not worry and please do not replace them.
Some stitches can be removed by yourself after six days. If you have received these instructions after your surgery, you will see a thin blue stitch after you have peeled off your Steristrip. You can hold one end of this stitch and just pull it out after seven days. This type of material is designed to slide out easily, there will be no pain and there is nothing you can do wrong.
Eyelid compresses
Making a cold compress:
- Put ice or crushed ice into a plastic bag and wrap with a moist flannel or tea towel (not dry). If it is too cold leave it for five minutes before applying it to your eyelid so that you don’t give yourself frostbite.
How do I apply a compress?
- Apply a cold compress six to eight times a day, or as frequently as you can bear, to your closed operated eye.
- Make sure the eye remains closed.
- Keep the compress on the eye for 15 minutes at a time.
After one week switch to warm compresses to closed eyelids. This is not essential but may help speed up resolution of established swelling. Apply a warm flannel for a few minutes, keeping the eye(s) closed.
Making a warm compress:
- Soak a clean flannel in warm water and squeeze out excess water. Make sure it is not too hot.
- Observe any swelling and discontinue warm compresses if it is getting worse.